<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Blue ERP - {$breadcumb}</title>
<link rel="stylesheet" href="{$template.url}css/style.css" type="text/css" />
</head>

<body>
    <center>
        <form id="namaMahasiswa" action="{site_url("hasilOrder")}" method="post">
        <table>
            <tr>
                <td colspan="6">
                    <div class="form-title" >
                        <span class="form-title-order">INFORMASI ORDER</span>
                    </div>
                </td>
            </tr>
            <tr>
                <td class="widthArea">Jumlah Item</td>
                <td colspan="5">
                    : <select name="jumlah_item">
                                <option value="1">1</option>

                                <option value="2">2</option>
                                <option value="3">3</option>
                                <option value="4">4</option>
                                <option value="5">5</option>
                                <option value="6">6</option>
                                <option value="7">7</option>

                                <option value="8">8</option>
                                <option value="9">9</option>
                                <option value="10">10</option>
                                <option value="11">11</option>
                                <option value="12">12</option>
                                <option value="13">13</option>

                                <option value="14">14</option>
                                <option value="15">15</option>
                                <option value="16">16</option>
                                <option value="17">17</option>
                                <option value="18">18</option>
                                <option value="19">19</option>

                                <option value="20">20</option>
                                <option value="21">21</option>
                                <option value="22">22</option>
                                <option value="23">23</option>
                                <option value="24">24</option>
                                <option value="25">25</option>

                                <option value="26">26</option>
                                <option value="27">27</option>
                                <option value="28">28</option>
                                <option value="29">29</option>
                                <option value="30">30</option>
                                <option value="31">31</option>

                                <option value="32">32</option>
                                <option value="33">33</option>
                                <option value="34">34</option>
                                <option value="35">35</option>
                                <option value="36">36</option>
                                <option value="37">37</option>

                                <option value="38">38</option>
                                <option value="39">39</option>
                                <option value="40">40</option>
                            </select>
                </td>
            </tr>
            <tr>
                <td class="widthArea">Nama Barang</td>
                <td colspan="5">: <input type="text" name="nama_barang" /></td>
            </tr>
            <tr>
                <td class="widthArea">URL Item</td>
                <td colspan="5">: <input type="text" name="url_item" /></td>
            </tr>
            <tr>
                <td class="widthArea">Jumlah</td>
                <td>
                    : <input type="text" name="jumlah" class="autoField" />
                </td>
                <td class="autoField">Ukuran</td>
                <td>
                    : <input type="text" name="ukuran" class="autoField" />
                </td>
                <td class="autoField">Warna</td>
                <td>
                    : <input type="text" name="warna" class="autoField" />
                </td>
            </tr>
            <tr>
                <td class="widthArea">Harga Item [$]</td>
                <td colspan="5">: <input type="text" name="harga_item" /></td>
            </tr>
            <tr>
                <td class="widthArea">Berat Item Aktual [KGs]</td>
                <td colspan="5">: <input type="text" name="berat_item_aktual" /></td>
            </tr>
            <tr>
                <td class="widthArea">Dimensi Item</td>
                <td class="autoField" colspan="2">:
                    <input type="text" name="d1" class="dimensionField" /> x
                    <input type="text" name="d2" class="dimensionField"/> x
                    <input type="text" name="d3" class="dimensionField" />
                </td>
            </tr>
            <tr>
                <td class="widthArea">Photo Item</td>
                <td colspan="5">: <input type="file" name="photo_item" /></td>
            </tr>
            <tr>
                <td class="widthArea">Shipping Cost</td>
                <td>: <input type="text" name="shipping_cost" class="autoField" /></td>
            </tr>
            <tr>
                <td colspan="6"><br/><div class="form-dash"></div></td>
            </tr>
            <tr>
                <td class="widthArea">Sub Total Order [USD]</td>
                <td colspan="5">: <input type="text" name="sub_total_order" /></td>
            </tr>
            <tr>
                <td class="widthArea">Services Charges [USD]</td>
                <td colspan="5">: <input type="text" name="services_charges" /></td>
            </tr>
            <tr>
                <td class="widthArea">Exchange Rate</td>
                <td colspan="5">: <input type="text" name="exchange_rate" class="autoField" /></td>
            </tr>
            <tr>
                <td class="widthArea">Order Grand Total</td>
                <td colspan="5">: <input type="text" name="order_grand_total" /></td>
            </tr>
            <tr>
                
            </tr>
            <tr>
                <td>
                    <div class="button-mask"><input class="button-form" type="submit" value="Submit" /></div>
                    <div class="button-mask"><input class="button-form" type="reset" value="Reset" /></div>
                </td>
                <td>
                </td>
            </tr>
        </table>
        </form>
    </center>
</body>
</html>
